Malaria and Neglected Tropical Diseases

Lord Bishop of St Albans Excerpts

Thursday 7th July 2022 Lords Chamber

[The Lord Bishop of St Albans]

My Lords, I thank the noble Lord, Lord Trees, for obtaining this important debate on a subject that really needs to be before your Lordships’ House more frequently and deserves a much higher profile. This is a topic of some interest to me because one of my colleagues, the Bishop of Hertford—last week, he became the Bishop of Bath and Wells—is a professional epidemiologist. I hope that he will be in this House in a few years, because he has spent a lot of his time—even though he has been a bishop—in Africa working on a variety of things such as malaria and Ebola. Thanks to him, I have become increasingly aware of just how important this area is and, as we come out of Covid, how vital it is that we grow human capital in these regions.

It was said to me that rather than calling them “neglected tropical diseases” it would be more apt to call them “tropical diseases of neglected peoples”, given the global economic status of their victims. While I am conscious that malaria is specifically referenced in this debate and that NTDs include a host of serious bacterial and viral infections, I want to focus my brief comments on the parasitical infections within the NTD umbrella, as these are really diseases of poverty. Parasitical infections such as worms are in many cases caught because of the social context in which people are living—poor sanitary conditions, lack of clean water and the inability to store or consume food safely. It is therefore no surprise that deworming programmes are a huge part of the global effort to combat NTDs.

Typically, the victims are school-age children, which is why the standard way of delivering these treatments is very often through schools. This is why the millennium development goals and the specific provision to achieve universal primary education are so crucial, because, as well as giving education, these are the places where parasitical infections can be treated. However, as we experienced during the Covid lockdowns and the gradual emergence from them, children in areas of the world where NTDs are prevalent were unable to attend their schools and were locked out of the treatment that they desperately needed. This created a backlog in the delivery of these treatments. It is important to emphasise that the delivery systems and infrastructure are equally important as any medication if we are going to sort this out. To be fair to some of our pharmaceutical companies, very often that medication is donated.

It is deeply regretful, therefore, to see the very sizeable cuts in foreign aid. Parents in this country would be rightly outraged if children were being infected with parasites which could be treated for as little as 50p—I think the noble Lord, Lord Trees, said 50 cents, but I thought it was 50p. The currency does not matter; it is pennies we are talking about. This is a minor amount of money yet, in some respects, by reducing our foreign aid funding, we are allowing these diseases to occur in the developing world. The real danger, as people face starvation, shortages and famine—and these NTDs—is that we potentially face mass migrations. It really makes sense for us to think about how we can make improvements in these other parts of the world.

The point about treating NTDs, especially parasites, is that by building the delivery infrastructure, such as schools, as well as better sanitary facilities to prevent infection in the first place, we are investing in the human capital of these nations. In rich countries, human populations constitute between 70% and 80% of the nation’s wealth. In low-income countries it is around 30% to 40%. The implication is that the majority of people in these countries fail to achieve their full potential. That is a tragedy for them as people and for the well-being of their nation. Therefore, when we talk about treating NTDs, it has to be within a wider framework of boosting human capital within nations. This occurs through direct treatment, which is extraordinarily cheap per child; supporting universal primary education, especially where women are concerned, since they are more likely to be locked out of primary education; and continuing to improve public health infrastructure in these areas.

All these things will improve treatment and human capital, which in itself will lift people out of poverty and prevent infection. Therefore, when we consider cuts in aid to the tune of £150 million for the elimination and eradication of NTDs, this is only one section of the funding required to address this problem, as it fails to account for the cuts in funding to help build the human capital that is so vital to combatting these diseases in the long run.

Many charities are doing their best to address these issues. Within the Anglican Church we have the Anglican Alliance, which is a major fundraiser trying to do that. Just this morning I chaired an online meeting with people from Mozambique, because my diocese is seeking to make a serious input into the north of that country to see whether we can give it a serious boost. The problem is that, despite all our voluntary efforts, it will not be enough without government help. I believe that is what we need urgently.

I finish by reiterating that foreign aid is an undeniable moral good, especially when we consider our good fortune in not being plagued by these diseases. That is not to say that we do not currently have problems at home, but it is about being mindful of our privilege and material well-being. The Covid pandemic has set back efforts to tackle NTDs, which makes it more important than ever to see what we can do to help these countries, which will also benefit us as being the right thing to do.